ABSTRACT
BACKGROUND: Previous study suggested that beef tallow extract including cis-9-cetylmyristoleate was a safe and effective treatment for patients with osteoarthritis. We used extract of vegetable oils containing cetyl myristoleate. This study assessed the effect of this supplementation on knee pain and function in patients with osteoarthritis. METHODS: The 70 patients who manifested the symptoms and signs of osteoarthritis of knee were randomly assigned to placebo (36) and plant-fatty acids complex (FAC) group (34). Two capsules of placebo (corn starch 350 mg) and plant-FAC (12% cetyl myristoleate in 350 mg) were orally administered to placebo and plant-FAC group three times a day for 60 day, respectively. Visual analogue scale (VAS) and Korean version of Western Ontario and McMaster's Universities Osteoarthritis Index (KWOMAC) were assessed before and after the intervention and we monitored any adverse effects. RESULTS: The 6 of 36 patients (16.7%) in the placebo and the 5 of 34 patients (14.7%) in the plant-FAC group were missed due to low compliance. In the plant-FAC group, the VAS score was improved by mean 0.76 (P = 0.03) but the improvement was lower than that of placebo group. The KWOMAC was improved by mean 8.90 and 8.13 in the plant-FAC and placebo group, respectively. But the independent t-test showed no statistical significance (P = 0.47). CONCLUSION: We failed to show the superiority of plant-FAC to placebo on the pain and function of patients with osteoarthritis of the knee.
Subject(s)
Humans , Capsules , Compliance , Fats , Fatty Acids , Knee , Ontario , Osteoarthritis , Osteoarthritis, Knee , Plant Oils , Starch , Vegetables , WaxesABSTRACT
BACKGROUND: Previous study suggested that beef tallow extract including cis-9-cetylmyristoleate was a safe and effective treatment for patients with osteoarthritis. We used extract of vegetable oils containing cetyl myristoleate. This study assessed the effect of this supplementation on knee pain and function in patients with osteoarthritis. METHODS: The 70 patients who manifested the symptoms and signs of osteoarthritis of knee were randomly assigned to placebo (36) and plant-fatty acids complex (FAC) group (34). Two capsules of placebo (corn starch 350 mg) and plant-FAC (12% cetyl myristoleate in 350 mg) were orally administered to placebo and plant-FAC group three times a day for 60 day, respectively. Visual analogue scale (VAS) and Korean version of Western Ontario and McMaster's Universities Osteoarthritis Index (KWOMAC) were assessed before and after the intervention and we monitored any adverse effects. RESULTS: The 6 of 36 patients (16.7%) in the placebo and the 5 of 34 patients (14.7%) in the plant-FAC group were missed due to low compliance. In the plant-FAC group, the VAS score was improved by mean 0.76 (P = 0.03) but the improvement was lower than that of placebo group. The KWOMAC was improved by mean 8.90 and 8.13 in the plant-FAC and placebo group, respectively. But the independent t-test showed no statistical significance (P = 0.47). CONCLUSION: We failed to show the superiority of plant-FAC to placebo on the pain and function of patients with osteoarthritis of the knee.
Subject(s)
Humans , Capsules , Compliance , Fats , Fatty Acids , Knee , Ontario , Osteoarthritis , Osteoarthritis, Knee , Plant Oils , Starch , Vegetables , WaxesABSTRACT
PURPOSE: Primary neuroendocrine tumor (PNET) of the liver is a very rare neoplasm. This study was conducted to analyze the clinical experience of 8 hepatic PNET cases. METHODS: Four male and 4 female patients with a mean age of 50.4 +/- 9.5 years (range 37-64 years) underwent liver resection for hepatic PNET between January 1997 and December 2006. The diagnosis was confirmed histologically using light microscopy and immunohistochemistry in the absence of an alternative primary site RESULTS: Curative resection was achieved in 6 of the 8 patients, and 5 of the patients were alive and disease free after a mean follow-up period of 47.6 months. However, 3 patients died 3, 5 and 26 months after surgery due to multiple liver metastasis. A proliferative index of Ki67 appeared to indicate a significant risk factor for tumor recurrence. Additionally, recurrence occurred in 1 of the 6 patients that underwent curative resection during the follow-up period. Overall, both the 5-year recurrence rate and the 5-year survival rate were 50%. CONCLUSIONS: Active exclusion of an extrahepatic primary site is essential for diagnosis of hepatic PNET. The primary treatment for PNET is curative liver resection, and a proliferative index of Ki67 appears to be a prognostic factor for tumor recurrence.
Subject(s)
Female , Humans , Male , Carcinoid Tumor , Diagnosis , Follow-Up Studies , Immunohistochemistry , Liver , Microscopy , Neoplasm Metastasis , Neuroectodermal Tumors, Primitive , Neuroendocrine Tumors , Recurrence , Risk Factors , Survival RateABSTRACT
Many liver recipients have required intensive care, which is individualized and customized to each recipient. Prerequisites qualifying this care are wide comprehension of characteristics of end-stage liver disease and mechanisms of surgical procedures and immunologic knowledge. We present our principles of intensive care and experience from more than 300 cases of liver transplantation. There are roughly two types of liver transplantation, cadaveric and living-donor. These two types are different in their postoperative courses as following; severity of preservation injury, graft-size matching and morphologic liver regeneration and risk of vascular and biliary complications. Intensive care for liver recipients should be directed toward preventive and protective care along reasonable prediction of its clinical course. We described our experience about following subjects: management of hepatorenal syndrome, fulminant hepatic failure, acute renal failure, pneumonia, disturbance of consciousness, prophylaxis of viral hepatitis B, tumor recurrence, use of antibiotics, induction of liver function recovery, maintenance of vital signs, electrolyte balance, diet and infection control, nutritional support. The most important factor is the state of transplanted liver graft in determination of posttransplant course. If the graft functions well, many problems will be solved spontaneously. If not, intensive care will be required. Most of operative complications are related to the surgery itself, so that comprehension to surgical procedures to each recipient should be preceded for early detection and proper management. To achieve a favorable posttransplant course, all factors including maintenance of vital signs, elimination of obstacles to hepatic recovery, appropriate immunosuppression and solution of surgical complications should be met altogether. Of course, every member of liver transplantation team should pay durable attention and dedication to each liver recipient.
Subject(s)
Acute Kidney Injury , Anti-Bacterial Agents , Cadaver , Comprehension , Consciousness , Diet , Fibrinogen , Hepatitis B , Hepatorenal Syndrome , Immunosuppression Therapy , Infection Control , Critical Care , Liver Diseases , Liver Failure, Acute , Liver Regeneration , Liver Transplantation , Liver , Nutritional Support , Pneumonia , Recovery of Function , Recurrence , Transplants , Vital Signs , Water-Electrolyte BalanceABSTRACT
There are many surgical alternatives to medical therapy for trigeminal neuralgia. Among open procedures, Jannetta's procedure for microvascular decompression have widest favor. But there is no justification for exposing patients to such dangers when there are effective and safe alternatives such as percutaneous procedures. Of the percutaneous procedures, the most widely used are thermocoagulation, glycerolization, and microcompression of the gasserian ganglion. Percutaneous microcompression of the gasserian ganglion was introduced by Mullan in 1978 and its description was published in 1983. In the 1950's and 1960's deliberate compression of the gasserian ganglion was performed through an open operation. Mullan carried out this precedure using an inflatable balloon under brief anesthesia. 15 procedures were performed under brief general anesthesia in order to ensure maximum comfort for the patient in the operating room. The instruments consisted of a 14 gauge blunt tip needle, a 4F Fogarty catheter and a tuberculin syringe. The compression was maintained usually for 1 to 1.5 minutes. 14 out of 15 patients were relieved from their pain without serious complications.
Subject(s)
Humans , Anesthesia , Anesthesia, General , Catheters , Electrocoagulation , Glycerol , Microvascular Decompression Surgery , Needles , Operating Rooms , Syringes , Trigeminal Ganglion , Trigeminal Neuralgia , TuberculinABSTRACT
Neurolytic or surgical lumbar sympathectomy are commonly used in the treatment of intractable pain and peripheral ischemia. The primary goal of sympathectomy for pain management is to achieve a good result with minimal interruption of nervous tissue and as few side effect as possible. A high incidence of postoperative bleeding, ureteral injuries have been reported in surgical sympathectomy and chemical neuritis or paresthesia has been reported with an incidence of 2~10% in nerurolytic sympathectomy. Of the techniques which have been applied for sympathectomy, the radiofrequency lesion method has emerged as the most effective with less complications. But, a series of modifications have been tried in an effort to improve results. The more extensive lesions are thought to produce the more effective sympatholysis. We inserted two cannulas for making lesions to one ganglion and 3 or 4 lesions were made at each level. Sympathectomy using this technique was successful in thirteen out of fifteen patients. This new modified technique has improved the effectiveness of stereotactic radiofrequency lumbar sympathectomy as compared with other previous reports.